Week in Review

In 1954 almost 35% of all workers belonged to a union. Since then that number has fallen to about 11.3%. As the high cost of union contracts chased manufacturing out of the country. Today the majority of workers belonging to a union work in the public sector. Where they enter contract negotiations with the taxpayers to secure better pay and benefits than most taxpayers have. Of course during these negotiations the taxpayers have no say. As politicians and unions hammer out these contracts. Unlike trade unions. Where the people paying the workers actually have a say.

This is another reason why national health care is the Holy Grail for the left. They want to unionize all those health care workers. Pay them more. And deduct union dues from their pay to fund their political activities. Leaving less money for patient health care. But they’re okay with that. But they’re not okay with a pharmaceutical company charging a lot of money for life-saving drugs. Which, also, leaves less money for patient health care (see Breast cancer drug turned down for NHS use due to high cost by Sarah Boseley posted 4/22/2014 on the guardian).

A Herceptin-style drug that can offer some women with advanced breast cancer nearly six months of extra life has been turned down for use in the NHS because of its high cost.

In draft guidance now open to consultation, the National Institute for Health and Care Excellence (Nice) blames the manufacturers, Roche, who are asking for more than £90,000 per patient, which is far more than any comparable treatment…

“We apply as much flexibility as we can in approving new treatments, but the reality is that given its price and what it offers to patients, it will displace more health benefit which the NHS could achieve in other ways, than it will offer to patients with breast cancer.”

Paying health care providers more will not improve the quality of health care. Unless health workers are doing a half-assed job now. Which I don’t believe they are. But Roche is helping people with death sentences live another six months or so. That’s a pretty remarkable thing. If the NHS can’t afford this wonder drug perhaps they should use their own. Of course they can’t. Why? Because they don’t have one. For they didn’t pour hundreds of millions of dollars in developing this drug and the all those drugs that failed.

Developing a miracle drug is costly. Money the pharmaceuticals pay up front. Because their employees don’t work for free. Which is why these drugs cost so much. That high price pays for all of the costs that went into this drug. For all of the drugs that failed. And provides a return for investors. Who give these pharmaceutical companies hundreds of millions of dollars up front just in the hope they may develop a miracle drug. Which is the only way we should invest in these miracle drugs. Because these investors will only take a chance on a good thing. Unlike government. Which has a history of backing the wrong investment time after time. And pouring good money after bad.

It’s a tough choice to make. Take health care benefits away from other patients to pay for a miracle drug for those dying from cancer. Or let people die 6 months or so sooner. One thing for sure, though, unionizing our health care workers won’t give either of these patients more health care benefits. It will only leave less money for everything else. Leading to rationing. And longer wait times. Because less money will pay for fewer things. Making those other things scarcer. Forcing people to wait longer and pay more for treatment.

Week in Review

China has recently privatized their health care system. Sort of. They have private health care providers and a state health insurance that helps pay for it with a small patient ‘co-pay’. Quality of care did increase. But health care providers don’t get paid a lot in China. And turn to other means of compensation that is not without its problems (see ‘Guardian angels’ to protect Chinese doctors from patients by Malcolm Moore posted 4/9/2014 on The Telegraph).

Hospitals in Beijing will recruit 1,500 “guardian angels” to protect their doctors from violent attacks by patients.

In recent years, angry patients have killed a number of Chinese doctors, often citing frustration at how they have been handled by the healthcare system…

Doctors and nurses in hospitals are violently attacked every two weeks on average, the state media said, by patients angry at long waiting times, high medical bills and haughty or uncaring doctors…

The government has promised to root out corruption in the healthcare system, and the Health Ministry said in February it would target patients who bribe doctors for better treatment.

Yes, bribes. Or hongbao, as it’s called in China. If you want some decent care in a Chinese hospital you have to slide an envelope with money in it to your health care provider. Otherwise you’ll only get what the state health insurance will buy you. Long waiting times, high medical bills (for what the state insurance doesn’t cover—a high deductible, if you will) and haughty or uncaring doctors. Which tells you how bad the health care system must have been before they privatized it. For it’s a lot better now than it used to be.

So China made their health care better by privatizing it (although it is still so bad that angry patients who paid good bribes for their loved one’s care are assaulting their doctors and nurses every two weeks on average). While the United States is going the other way. Towards more state control. Pity the Obama administration can’t be more like China when it comes to health care. And try to improve the quality of health care instead of making it worse. Which they will likely do as their cost saving measure is simply to pay health care providers less. Which will likely discourage doctors from entering the system. Or remaining in the system. Leading to longer waiting times. And, perhaps, bribes. At least from those who want good care for their loved ones.

Week in Review

The problem with national health care is simple economics. Supply and demand. Things that cost more are in lower demand. Things that cost less are in higher demand. And free things are over consumed.

In Britain they have the NHS. The National Health Service. It’s not health insurance. Like Obamacare is. It is health care funded by the taxpayers. What they designed Obamacare to become. After causing businesses to drop costly mandated health insurance for their employers. And making it near impossible for private health insurers to remain in the insurance business. Once they meet these objectives then the government can transform Obamacare more into something like the NHS. Where people get ‘free’ health care. Paid for not by private insurance policies. But from the tax revenue of the federal government. Where they can over consume all the free health care they can get their hands on. Such as demanding antibiotics every time they get the sniffles.

Sounds good to some. Primarily to those who don’t have health insurance. Because they choose not to pay for it. Why? Because it is so expensive. And it’s so expensive because health insurance is no longer insurance. Because it covers almost everything. Instead of just the large, unexpected, catastrophic expenses. The things insurance used to pay for. While we paid for checkups and routine doctor visits out of pocket. So we paid for the little things that we could expect and budget for. While buying insurance for the things we could not expect or budget for. And the system worked. It kept costs under control because we were paying for most of what we were receiving. Creating a direct relationship between the services we received and the money we spent. Which introduced market forces into the equation. But ever since health insurance became an employee benefit there have been fewer and fewer market forces in the equation. Which has lead to the explosion in health care costs.

Nationalizing health care only removes market force from the equation further. Which will, of course, raise costs. As there will be nothing to keep health providers efficient while maintaining high standards of quality. For if their customers aren’t paying them they don’t have to please their customers with efficiency or high quality care. They just have to meet the minimum state requirements. And keep asking the government for more money. Until the government has no money to give.

And as a large health bureaucracy develops things become more impersonal. More machine like. Where patients are units of input. That have to be processed according to strict bureaucratic guidelines. Not necessarily what’s best for the patient. The amount of paperwork rises. And health care providers spend more time pushing paper than interacting with units of input. Patients. People at the hospital must bow to the distant health care authority. Often following rules and regulations that don’t make sense all of the time. Frustrating them. And making them apathetic in their jobs.

Then efficiencies fall. And costs rise. Health care providers are forced to do more with less. Spreading their limited resources over more and more patients. Unable to provide high quality to everyone they do just the minimum for everyone. While their apathy turns to indifference to their patients’ wellbeing. You create an environment like this eventually over time you get this (see ‘Up To 13,000 Needless Deaths’ In NHS Hospitals posted 7/14/2013 on Sky News).

Up to 13,000 people may have died needlessly in NHS hospitals since 2005, according to a report to be published in the coming days…

The report, to be released on Tuesday, will criticise care standards and management failures, fuelling concerns about a problem with the NHS’s culture where whistleblowers are afraid to speak out and regulators often fail to do their job…

Sir Bruce examined not just mortality rates, but measurements including infection levels, the number of patients suffering from preventable and potentially fatal signs of neglect, and the numbers harmed by so-called “never events” such as operations on the wrong part of the body, or surgical instruments left inside a patient.

National health care will eventually poison the greatest assets of the health care system. Its people. Taking a good system and making it bad over time. And you know it’s bad when ‘surgical instruments left inside a patient’ is a metric they track. Apparently because it happens so often that it is something that they can count.

So take a good look. This is national health care. The ultimate destination of Obamacare. Which will kill some 65,000 people over 8 years (the U.S. has about five times the population of Britain so they will have five times the number of needless deaths). That comes to about 8,125 a year. Which isn’t that far below the national homicide rate. Imagine that. Raising deaths in our health care system to near the national homicide rate. That’s what we can expect with Obamacare. As our health care system struggles to do more with less. Overwhelming our heath care providers. And making them grow ever more apathetic. Just like they have in Britain.